Mild Brain Injury

Mild brain injury (MBI) is a disease that is commonly caused by a significant blow to the head from a sports-related injury, motor vehicle accident, an accidental fall, or an assault. Although the vast majority of concussive injuries improve through natural recovery, some require medical, psychological and rehabilitative efforts to manage lingering symptoms. Other causes of MBI, such as a loss of oxygen to the brain, intracranial bleeding, or surgical procedures for an aneurysm or brain tumor, also require specialized interventions. In either case, the moderate changes that people experience in their thinking, emotional or physical abilities may create feelings of worry and demoralization.

The Mild Brain Injury Program is designed to rehabilitate individuals who have sustained a recent brain injury or to work with those whose longstanding MBI-related symptoms have not resolved. Best outcomes occur when MBI is treated immediately, clear information is provided and consistent follow-up services are offered. However, for those who have not received such care and have lingering symptoms, much can be done to improve their daily functioning.

Our comprehensive, coordinated treatment approach utilizes a team of rehabilitation experts, ensuring the best in MBI treatment. We encourage those who have experienced brain injury to contact us with any questions about these programs and to use us as a resource in making medical decision making. Please call 410-601-1199 to speak with one of our MBI Case Managers.

Those who have sustained an MBI may experience some or many of these changes, depending on the type and location of the brain injury. In most cases, these symptoms resolve naturally over time with rest and relaxation. However, not everyone recovers at the same rate or has the same outcome. One’s age and health status may affect recuperation. In addition, having sustained previous concussions complicates the healing process. Doctors who treat brain injuries agree that the most important factor in patients' recuperation is that they receive MBI education that improves their understanding of the recovery process and how to manage symptoms. The benefit of early detection and management of MBI symptoms cannot be overstated.

Treatment Approach

The Mild Brain Injury Program at Sinai Rehabilitation Center is designed to thoroughly diagnose and treat symptoms of MBI. Early in recovery, medical care focuses on promoting proper rest and sleep, reducing pain from headaches or other sources, managing visual changes, and treating balance issues for safety purposes. When this approach is followed, most people with MBI show significant improvement in concussion-related symptoms in the first month after injury.

For those individuals whose MBI symptoms do not improve after the first 4–6 weeks post-injury, much can still be done to promote recovery and restore function. Diagnostic clarity is critical in treating lingering symptoms of MBI. A slow recovery may be caused by the nature of the injury itself or the indirect effects of consistently poor sleep, visual changes or headaches. Psychological reactions to the trauma may also play a negative role in recovery from MBI.

Using a comprehensive diagnostic approach, the Mild Brain Injury Program assists patients in understanding the root causes of symptoms and provides a full complement of therapeutic options necessary for recovery. Our interdisciplinary treatment team works together to decide on a collaborative clinical approach and regularly reviews progress during team conferences. This information is also shared with patients to promote a clear understanding. The goal in MBI treatment is to improve an individual’s everyday life and allow them greater satisfaction in their pursuits.

Rehabilitation Experts and Programs

Our comprehensive, coordinated rehabilitation team works together to
provide the advanced care, expertise and resources necessary to treat persons
with MBI. We believe that everyone deserves compassionate, personalized
attention throughout the continuum of care, from evaluation and diagnosis to
rehabilitation and recovery. Specialist teams are personalized for each patient
and may include any or all of the following:

A medical doctor who is board certified in physical medicine and rehabilitation.
This physician oversees rehabilitation and manages physical, cognitive and
emotional symptoms that influence recovery and well-being. The physiatrist
often prescribes evaluations, therapies and medications to thoroughly treat
MBI.

Neurologist

A physician who specializes in neurology and is trained to diagnose and
treat neurologic disorders such as brain injury and stroke.

NeuropsychologistA specially trained psychologist who evaluates brain functioning after
an injury, particularly a person’s thinking and perceptual skills. Neuropsychologists
can pinpoint areas of decline and make treatment recommendations to improve
functional abilities. They also provide a psychological perspective in the
treatment process that aids in understanding the impact of psychological
factors on recovery.

Case ManagerThe case manager works with the interdisciplinary team to assess, plan
and coordinate care and provides patients with education and resources to
ensure positive outcomes. At the first contact with patients, the case manager gathers
information about the particulars of the brain injury and the ways in which it
affects daily activities. This information is shared with the physician in
charge of the patient's care and with other clinicians to whom the patient is
referred. The case manager ensures good communication among care team members throughout
the entire treatment period and serves as the primary contact for the patient. Patient
recovery is greatly enhanced by timely communication and case management
oversight.

Speech Language Pathology (SLP)The speech language pathologist assesses and treats deficits in
cognitive-communicative impairments, including attention/concentration, memory,
abstract reasoning and problem-solving. The primary goal in speech language
pathology care is to improve information processing, thought organization, initiation
and decision-making skills. A major focus in this treatment is teaching patients
compensatory strategies that promote a successful return to school or work.
Assistive technologies may also be employed to maximize daily functioning.

Occupational Therapy (OT)An occupational therapist works to improve an individual’s ability to
participate in activities of everyday life. After an MBI, fine motor skills,
eye-hand coordination and other ocular-motor functioning may be
diminished. The occupational therapist will develop a treatment plan that
improves brain function in these areas.

Physical Therapy (PT)The role of the physical therapist is to evaluate physical abilities
such as balance, endurance, strength, range of motion, and mobility. A frequent
but overlooked problem after a concussion involves an individual’s vestibular
system, which regulates the body’s ability to balance and know its position in
space. Our physical therapists have received specialty training in vestibular
rehabilitation and can develop a treatment plan to improve MBI-related
dizziness and balance deficits.

Rehabilitation Psychology/CounselingThe psychologist helps people with depression, anxiety, post-traumatic
stress disorder (PTSD), relationship stressors and other reactions to life
changes brought about by brain injury/stroke. Treatment includes education for
the patient and family and counseling regarding adjustment to disability

Driving Training and EvaluationAn occupational therapist provides clinical and on-the-road assessments
of vision, reaction time, thinking skills, memory, and physical function to
determine one’s ability to safely drive in the community following MBI. Behind-the-wheel
training and recommendations for adaptive equipment are also available.

Sleep Disorder CenterTheSinai Sleep Centerprovides an overnight evaluation through which sleep disorders can be diagnosed, and recommendations for treatment can be offered by sleep medicine specialists. This evaluation requires a prescription from a referring physician.

Neuro-OphthalmologyNeuro-ophthalmologists of Sinai’s Kreiger Eye Institute evaluate
patients from a neurologic, ophthalmologic and medical viewpoint. They
specialize in treating a wide variety of visual problems that result from MBI.

Pain ManagementPhysiatrists who specializes in pain disorders are available to manage
MBI-related pain. They incorporate patient medical history in identifying the
cause of the pain and develop a holistic treatment plan. A wide range of
treatment options may be utilized that focus on providing primary pain relief
and improved function and quality of life.

Admission Process

Persons seeking treatment for Mild Brain Injury (MBI are encouraged to call our case manager at 410-601-1199. An initial interview with the case manager will be arranged for the purpose of gathering information and determining if the program appropriately meets your needs. After this initial screening, patients are scheduled with either a physiatrist or neurologist for a thorough medical examination.

Contact Us:

RESOURCES

Brain Injury Association of Maryland, Inc.
A private, non-profit state affiliate of the Brain Injury Association of America. BIAM’s mission is to create a better future through brain injury prevention, education, advocacy and promotion of research.

Brain Injury Association of America, Inc.
National organization dedicated to people with brain injury and their families. Offers research, education, and advocacy programs through a national office, network of state affiliates, support groups, and a helpline.

Brain Trauma Foundation
Nationwide organization devoted to improving the outcome of traumatic brain injury patients. Focuses on the acute phase of traumatic brain injury (TBI) and methods to improve chances of a meaningful recovery. The Foundation works to improve the care of TBI patients from the scene of injury to the emergency room and ICU through guidelines development, professional education, quality improvement, and clinical research.

Family Caregiver Alliance/ National Center on Caregiving
Supports and assists families and caregivers of adults with debilitating health conditions. Offers programs and consultation on caregiving issues at local, state, and national levels. Offers free publications and support online, including a national directory of publicly funded caregiver support programs.

National Stroke Association
National non-profit organization that offers education, services and community-based activities in prevention, treatment, rehabilitation and recovery. Serves the public and professional communities, people at risk, patients and their health care providers, stroke survivors, and their families and caregivers.

BrainLine.org provides a wide
variety of information on brain injury for both professionals and survivors of
brain injury. It is a WETA website that is funded by the Defense and Veterans Brain
Injury Center through a
contract with the Henry M. Jackson Foundation.